Pharm Block 1e

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Pharm Block 1e
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2010-11-01 21:17:09
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Pharm Block 1e
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  1. What are some uses of Beta blockers? HINT 9 uses
    • HTN
    • IHD (Ischemic heart disease)
    • Arrhythmia
    • CCF (congestive cardiac failure)--- only low dose in mild and moderate patients (not sever because at that point herart is dependent on SNS input).
    • Glaucoma
    • Hyperthyroidism
    • Pheochromocytoma
    • Migraine Prophylaxis
    • Anxiety of manic attacks
  2. What will Chronic Beta blocker theropy with a sudden with drawl result in?
    Results in Rebound hypertension and angina

    Note:Since you give Beta blockers for a long time, the body response by increasing the Beta blocker recepters.
  3. What are Nicotinic (muscle) receptor blockers?
    What are nicotinic (nerve) receptor blockers?
    • -Skeletal muscle relaxants
    • - Ganglion blockers (block both SNS and PNS)
  4. When might you used Skeletal muscle relaxants?
    • adjuvant in general anesthesia (unconciousness, analgesic, and muscle relaxant)
    • Brief procedure- reduction of fractures (when there is a muscle spasm)
  5. What are the different types of skeletal muslce relaxants?
    • Competative (non-depolarizing)
    • Non-Competative (depolarising)


    Directly acting muscle relaxants
  6. Where do Skeletal Muscle relaxants block?
    Peripherally at the neuromuscular junction.
  7. What is Succinylcholine metabolized by?
    What happens to Cisatracurium in the plasma?
    • - Pseudocholinesterase
    • - Inactivated in plasma by spontanious non-enzymatic degradation (hoffman elimination)
  8. What are the Neuromuscular non-depolarizing (competative) blockers?
    Which are long, intermediate and short acting?
    Pancuronium, Pipecuronium Long acting

    Rocuronium, Cisatracurium Medium acting

    Mivacurium Short acting
  9. What are the Neuromuscular depolarizing (non-competative) blockers?
    Succinylcholine The shortest acting
  10. __________ is the only skeletal muscle relaxant that is not reversed by__________.
    Succinylcholine

    Neostagmine
  11. Succinylcholine, what are its effects?
    Causes:

    • Muscle pain
    • Hyperkalemia
    • Malignant Hyperthermia (due to severe muscle spasms)
    • and Succinylcholine apnea in pseudocholinesterase deficiency.
  12. What are the effects of Competative skeletal muscle relaxants?
    What is their paralysis?
    What is Neostagmines effects?
  13. -Block Nicotinic (Nm) receptors at the muscle end plates but have no intrinsic activity.
    • - Flaccid
    • -Antagonizes and thus reverse the effects
  14. What are the effects of non-Competative skeletal muscle relaxants?
    What is their paralysis?
    What is Neostagmines effects?
    • -Succinylcholine open Na channels which cause initial twitching and fasciculations followed by desensitization of receptor
    • - Fasciculations--> Flaccid Paralysis
    • - Exaggerate/ to no effect
  15. Name a Directly acting muscle relaxant?
    What are its effects?
    When is it used clinically?
    • Detrolene
    • Depolarization triggered release of calcium from the sarcoplasmic contraction is {ryanodine receptor(RyR) } blocked / reduced.

    • •used to reduces spasticity in hemiplegia and cerebral palsy.
    • •It is the drug of choice – malignant hyperthermia
  16. Examples of centrally acting skeletal muscle relaxants :
  17. •Methocarbamol,
    • •Chlorzoxazone
    • •Diazepam – GABA-A receptor
    • •Baclofen – GABA-B receptor – less sedation
    • •Tizanidine – central acting alpha-2 agonist--> decrease in Glut

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